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1.
Proc Natl Acad Sci U S A ; 120(13): e2217084120, 2023 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-36943876

RESUMO

More than half of all extant metazoan species on earth are insects. The evolutionary success of insects is linked with their ability to osmoregulate, suggesting that they have evolved unique physiological mechanisms to maintain water balance. In beetles (Coleoptera)-the largest group of insects-a specialized rectal ("cryptonephridial") complex has evolved that recovers water from the rectum destined for excretion and recycles it back to the body. However, the molecular mechanisms underpinning the remarkable water-conserving functions of this system are unknown. Here, we introduce a transcriptomic resource, BeetleAtlas.org, for the exceptionally desiccation-tolerant red flour beetle Tribolium castaneum, and demonstrate its utility by identifying a cation/H+ antiporter (NHA1) that is enriched and functionally significant in the Tribolium rectal complex. NHA1 localizes exclusively to a specialized cell type, the leptophragmata, in the distal region of the Malpighian tubules associated with the rectal complex. Computational modeling and electrophysiological characterization in Xenopus oocytes show that NHA1 acts as an electroneutral K+/H+ antiporter. Furthermore, genetic silencing of Nha1 dramatically increases excretory water loss and reduces organismal survival during desiccation stress, implying that NHA1 activity is essential for maintaining systemic water balance. Finally, we show that Tiptop, a conserved transcription factor, regulates NHA1 expression in leptophragmata and controls leptophragmata maturation, illuminating the developmental mechanism that establishes the functions of this cell. Together, our work provides insights into the molecular architecture underpinning the function of one of the most powerful water-conserving mechanisms in nature, the beetle rectal complex.


Assuntos
Tribolium , Animais , Tribolium/genética , Tribolium/metabolismo , Prótons , Antiporters/metabolismo , Reto/metabolismo , Água/metabolismo
2.
Plant Physiol ; 194(2): 1166-1180, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-37878763

RESUMO

Calcium (Ca2+) is a major ion in living organisms, where it acts as a second messenger for various biological phenomena. The Golgi apparatus retains a higher Ca2+ concentration than the cytosol and returns cytosolic Ca2+ to basal levels after transient elevation in response to environmental stimuli such as osmotic stress. However, the Ca2+ transporters localized in the Golgi apparatus of plants have not been clarified. We previously found that a wild-type (WT) salt-tolerant Arabidopsis (Arabidopsis thaliana) accession, Bu-5, showed osmotic tolerance after salt acclimatization, whereas the Col-0 WT did not. Here, we isolated a Bu-5 background mutant gene, acquired osmotolerance-defective 6 (aod6), which reduces tolerance to osmotic, salt, and oxidative stresses, with a smaller plant size than the WT. The causal gene of the aod6 mutant encodes CATION CALCIUM EXCHANGER4 (CCX4). The aod6 mutant was more sensitive than the WT to both deficient and excessive Ca2+. In addition, aod6 accumulated higher Ca2+ than the WT in the shoots, suggesting that Ca2+ homeostasis is disturbed in aod6. CCX4 expression suppressed the Ca2+ hypersensitivity of the csg2 (calcium sensitive growth 2) yeast (Saccharomyces cerevisiae) mutant under excess CaCl2 conditions. We also found that aod6 enhanced MAP kinase 3/6 (MPK3/6)-mediated immune responses under osmotic stress. Subcellular localization analysis of mGFP-CCX4 showed GFP signals adjacent to the trans-Golgi apparatus network and co-localization with Golgi apparatus-localized markers, suggesting that CCX4 localizes in the Golgi apparatus. These results suggest that CCX4 is a Golgi apparatus-localized transporter involved in the Ca2+ response and plays important roles in osmotic tolerance, shoot Ca2+ content, and normal growth of Arabidopsis.


Assuntos
Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/metabolismo , Cálcio/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Complexo de Golgi/metabolismo , Rede trans-Golgi/metabolismo , Proteínas de Membrana Transportadoras/metabolismo , Saccharomyces cerevisiae/metabolismo
3.
Bioessays ; 45(9): e2300011, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37327252

RESUMO

Osmoregulation in insects is an essential process whereby changes in hemolymph osmotic pressure induce the release of diuretic or antidiuretic hormones to recruit individual osmoregulatory responses in a manner that optimizes overall homeostasis. However, the mechanisms by which different osmoregulatory circuits interact with other homeostatic networks to implement the correct homeostatic program remain largely unexplored. Surprisingly, recent advances in insect genetics have revealed several important metabolic functions are regulated by classic osmoregulatory pathways, suggesting that internal cues related to osmotic and metabolic perturbations are integrated by the same hormonal networks. Here, we review our current knowledge on the network mechanisms that underpin systemic osmoregulation and discuss the remarkable parallels between the hormonal networks that regulate body fluid balance and those involved in energy homeostasis to provide a framework for understanding the polymodal optimization of homeostasis in insects.


Assuntos
Osmorregulação , Equilíbrio Hidroeletrolítico , Animais , Equilíbrio Hidroeletrolítico/fisiologia , Homeostase , Pressão Osmótica , Insetos
4.
Proc Natl Acad Sci U S A ; 119(23): e2121469119, 2022 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-35658077

RESUMO

Recent studies have revealed a surprising diversity of sex chromosomes in vertebrates. However, the detailed mechanism of their turnover is still elusive. To understand this process, it is necessary to compare closely related species in terms of sex-determining genes and the chromosomes harboring them. Here, we explored the genus Takifugu, in which one strong candidate sex-determining gene, Amhr2, has been identified. To trace the processes involved in transitions in the sex-determination system in this genus, we studied 12 species and found that while the Amhr2 locus likely determines sex in the majority of Takifugu species, three species have acquired sex-determining loci at different chromosomal locations. Nevertheless, the generation of genome assemblies for the three species revealed that they share a portion of the male-specific supergene that contains a candidate sex-determining gene, GsdfY, along with genes that potentially play a role in male fitness. The shared supergene spans ∼100 kb and is flanked by two duplicated regions characterized by CACTA transposable elements. These results suggest that the shared supergene has taken over the role of sex-determining locus from Amhr2 in lineages leading to the three species, and repeated translocations of the supergene underlie the turnover of sex chromosomes in these lineages. These findings highlight the underestimated role of a mobile supergene in the turnover of sex chromosomes in vertebrates.


Assuntos
Processos de Determinação Sexual , Takifugu , Animais , Elementos de DNA Transponíveis/genética , Evolução Molecular , Cromossomos Sexuais/genética , Processos de Determinação Sexual/genética , Takifugu/genética , Translocação Genética
5.
PLoS Genet ; 17(11): e1009916, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34843450

RESUMO

Insect metamorphosis is triggered by the production, secretion and degradation of 20-hydroxyecdysone (ecdysone). In addition to its role in developmental regulation, increasing evidence suggests that ecdysone is involved in innate immunity processes, such as phagocytosis and the induction of antimicrobial peptide (AMP) production. AMP regulation includes systemic responses as well as local responses at surface epithelia that contact with the external environment. At pupariation, Drosophila melanogaster increases dramatically the expression of three AMP genes, drosomycin (drs), drosomycin-like 2 (drsl2) and drosomycin-like 5 (drsl5). We show that the systemic action of drs at pupariation is dependent on ecdysone signalling in the fat body and operates via the ecdysone downstream target, Broad. In parallel, ecdysone also regulates local responses, specifically through the activation of drsl2 expression in the gut. Finally, we confirm the relevance of this ecdysone dependent AMP expression for the control of bacterial load by showing that flies lacking drs expression in the fat body have higher bacterial persistence over metamorphosis. In contrast, local responses may be redundant with the systemic effect of drs since reduction of ecdysone signalling or of drsl2 expression has no measurable negative effect on bacterial load control in the pupa. Together, our data emphasize the importance of the association between ecdysone signalling and immunity using in vivo studies and establish a new role for ecdysone at pupariation, which impacts developmental success by regulating the immune system in a stage-dependent manner. We speculate that this co-option of immune effectors by the hormonal system may constitute an anticipatory mechanism to control bacterial numbers in the pupa, at the core of metamorphosis evolution.


Assuntos
Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Metamorfose Biológica/genética , Animais , Peptídeos Antimicrobianos/genética , Drosophila melanogaster/crescimento & desenvolvimento , Ecdisona/genética , Ecdisterona/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Larva/genética , Larva/crescimento & desenvolvimento , Pupa/genética , Pupa/crescimento & desenvolvimento , Transdução de Sinais/genética
6.
Proc Natl Acad Sci U S A ; 118(14)2021 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-33785598

RESUMO

Maintaining internal salt and water balance in response to fluctuating external conditions is essential for animal survival. This is particularly true for insects as their high surface-to-volume ratio makes them highly susceptible to osmotic stress. However, the cellular and hormonal mechanisms that mediate the systemic control of osmotic homeostasis in beetles (Coleoptera), the largest group of insects, remain largely unidentified. Here, we demonstrate that eight neurons in the brain of the red flour beetle Tribolium castaneum respond to internal changes in osmolality by releasing diuretic hormone (DH) 37 and DH47-homologs of vertebrate corticotropin-releasing factor (CRF) hormones-to control systemic water balance. Knockdown of the gene encoding the two hormones (Urinate, Urn8) reduces Malpighian tubule secretion and restricts organismal fluid loss, whereas injection of DH37 or DH47 reverses these phenotypes. We further identify a CRF-like receptor, Urinate receptor (Urn8R), which is exclusively expressed in a functionally unique secondary cell in the beetle tubules, as underlying this response. Activation of Urn8R increases K+ secretion, creating a lumen-positive transepithelial potential that drives fluid secretion. Together, these data show that beetle Malpighian tubules operate by a fundamentally different mechanism than those of other insects. Finally, we adopt a fluorescent labeling strategy to identify the evolutionary origin of this unusual tubule architecture, revealing that it evolved in the last common ancestor of the higher beetle families. Our work thus uncovers an important homeostatic program that is key to maintaining osmotic control in beetles, which evolved parallel to the radiation of the "advanced" beetle lineages.


Assuntos
Evolução Molecular , Túbulos de Malpighi/fisiologia , Tribolium/fisiologia , Equilíbrio Hidroeletrolítico , Animais , Encéfalo/citologia , Encéfalo/fisiologia , Hormônios de Inseto/metabolismo , Túbulos de Malpighi/citologia , Neurônios/fisiologia , Tribolium/genética
7.
Development ; 147(14)2020 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-32631830

RESUMO

The activation of a neuroendocrine system that induces a surge in steroid production is a conserved initiator of the juvenile-to-adult transition in many animals. The trigger for maturation is the secretion of brain-derived neuropeptides, yet the mechanisms controlling the timely onset of this event remain ill-defined. Here, we show that a regulatory feedback circuit controlling the Drosophila neuropeptide Prothoracicotropic hormone (PTTH) triggers maturation onset. We identify the Ecdysone Receptor (EcR) in the PTTH-expressing neurons (PTTHn) as a regulator of developmental maturation onset. Loss of EcR in these PTTHn impairs PTTH signaling, which delays maturation. We find that the steroid ecdysone dose-dependently affects Ptth transcription, promoting its expression at lower concentrations and inhibiting it at higher concentrations. Our findings indicate the existence of a feedback circuit in which rising ecdysone levels trigger, via EcR activity in the PTTHn, the PTTH surge that generates the maturation-inducing ecdysone peak toward the end of larval development. Because steroid feedback is also known to control the vertebrate maturation-inducing hypothalamic-pituitary-gonadal axis, our findings suggest an overall conservation of the feedback-regulatory neuroendocrine circuitry that controls the timing of maturation initiation.


Assuntos
Proteínas de Drosophila/metabolismo , Hormônios de Inseto/metabolismo , Receptores de Esteroides/metabolismo , Animais , Tamanho Corporal , Drosophila/crescimento & desenvolvimento , Drosophila/metabolismo , Proteínas de Drosophila/antagonistas & inibidores , Proteínas de Drosophila/genética , Ecdisterona/farmacologia , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Hormônios de Inseto/antagonistas & inibidores , Hormônios de Inseto/genética , Larva/crescimento & desenvolvimento , Larva/metabolismo , Metamorfose Biológica , Microscopia de Fluorescência , Neurônios/metabolismo , Interferência de RNA , RNA Guia de Cinetoplastídeos/metabolismo , Receptores de Esteroides/antagonistas & inibidores , Receptores de Esteroides/genética , Transdução de Sinais
8.
PLoS Genet ; 16(4): e1008727, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32339168

RESUMO

The human 22q11.2 chromosomal deletion is one of the strongest identified genetic risk factors for schizophrenia. Although the deletion spans a number of known genes, the contribution of each of these to the 22q11.2 deletion syndrome (DS) is not known. To investigate the effect of individual genes within this interval on the pathophysiology associated with the deletion, we analyzed their role in sleep, a behavior affected in virtually all psychiatric disorders, including the 22q11.2 DS. We identified the gene LZTR1 (night owl, nowl) as a regulator of night-time sleep in Drosophila. In humans, LZTR1 has been associated with Ras-dependent neurological diseases also caused by Neurofibromin-1 (Nf1) deficiency. We show that Nf1 loss leads to a night-time sleep phenotype nearly identical to that of nowl loss and that nowl negatively regulates Ras and interacts with Nf1 in sleep regulation. Furthermore, nowl is required for metabolic homeostasis, suggesting that LZTR1 may contribute to the genetic susceptibility to obesity associated with the 22q11.2 DS. Knockdown of nowl or Nf1 in GABA-responsive sleep-promoting neurons elicits the sleep phenotype, and this defect can be rescued by increased GABAA receptor signaling, indicating that Nowl regulates sleep through modulation of GABA signaling. Our results suggest that nowl/LZTR1 may be a conserved regulator of GABA signaling important for normal sleep that contributes to the 22q11.2 DS.


Assuntos
Síndrome da Deleção 22q11/genética , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas de Drosophila/genética , Neurônios GABAérgicos/metabolismo , Neurofibromina 1/genética , Esquizofrenia/genética , Sono/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Animais , Drosophila , Proteínas de Drosophila/metabolismo , Neurônios GABAérgicos/fisiologia , Humanos , Neurofibromina 1/metabolismo , Receptores de GABA-A/metabolismo , Fatores de Transcrição/genética
9.
J Infect Chemother ; 28(11): 1558-1561, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35921966

RESUMO

BACKGROUND: Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. CSD follows a typical course, characterized by regional lymphadenopathy. In atypical CSD, the lesions spread to systemic organs and can cause fever of unknown origin (FUO). A previous study showed the usefulness of whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted imaging (DWI) for limited areas in the diagnosis of FUO, but there are no studies on the clinical utility of whole-body DWI (WB-DWI). We herein report the case of an immunocompetent young man in whom contrast-enhanced CT-unidentifiable multiple liver abscess and osteomyelitis were successfully detected by WB-DWI. Follow-up with a liver biopsy helped confirm an atypical CSD diagnosis. CASE PRESENTATION: A 23-year-old previously healthy man was admitted for a 19-day history of high fever despite 3-day treatment by azithromycin. His physical examination was unremarkable and contrast-enhanced CT showed only a low attenuated area in the right lobe of the liver, indicating a cyst. WB-DWI revealed multiple nodular lesions of hypo-diffusion in the liver, spine, and pelvic region. The biopsy specimens of the liver abscess showed no evidence of tuberculosis/malignancy and the polymerase chain reaction (PCR) test of liver abscess aspirate showed positive findings for Bartonellahenselae, confirming the diagnosis of CSD. He completed minocycline monotherapy for a total of 60 days without any deterioration. CONCLUSIONS: WB-DWI can be useful for the diagnosis of atypical CSD with hepatic and bone involvement, which can cause FUO in young immunocompetent adults.


Assuntos
Bartonella henselae , Doença da Arranhadura de Gato , Febre de Causa Desconhecida , Abscesso Hepático , Doença da Arranhadura de Gato/diagnóstico por imagem , Doença da Arranhadura de Gato/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Imagem Corporal Total
10.
Hinyokika Kiyo ; 68(8): 265-269, 2022 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-36071018

RESUMO

A 65-year-old man was found to have a 1.7 cm right renal mass by follow-up abdominal computed tomography for left total nephrectomy after a traffic accident. The renal mass progressed slowly to 2.2 cm in three years and enhanced magnetic resonance imaging revealed marked T2 weighting hyperintensity of the lesion. Although a radiologist (TK) suggested the diagnosis renal anastomosing hemangioma preoperatively, we could not deny the possibility of renal cell carcinoma completely. Therefore, the patient underwent robot-assisted laparoscopic partial nephrectomy. The tumor was successfully removed without any renal arterial clamping or parenchymal excision. Histopathologically, the lesion was composed of capillary-size blood vessels lined by a single layer of endothelial cells, and was diagnosed as a renal anastomosing hemangioma. There were no signs of postoperative recurrence during the 3 month follow-up.


Assuntos
Carcinoma de Células Renais , Hemangioma , Neoplasias Renais , Idoso , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Células Endoteliais/patologia , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Masculino , Nefrectomia/métodos
11.
Cancer Sci ; 112(11): 4478-4489, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34545658

RESUMO

IL-2 is a pleiotropic cytokine that regulates immune cell homeostasis. Its immunomodulatory function has been used clinically as an active immunotherapy agent for metastatic cancers. However, severe adverse effects, including the vascular leak syndrome and the preferential stimulation of anti-immunogenic Treg rather than effector T cells, have been obstacles. We newly designed a mutein IL-2, Mutakine-6 (MK-6), with reduced IL-2Rα-binding capability. MK-6 induced comparable cell growth potential toward IL-2Rßγ-positive T cells but was far less efficient in in vitro Treg proliferation and STAT5 activation. Unlike IL-2, in vivo administration of MK-6 produced minimal adverse effects. Using CT26 and B16F10-syngeneic tumor models, we found MK-6 was highly efficacious on tumor regression. Serum albumin conjugation to MK-6 prolonged in vivo half-life and accumulated in CT26 tumors, showing enhanced antitumor effect. Tumor-infiltrating leukocytes analysis revealed that albumin-fused MK-6 increased the ratio of effector CD8+ T cells to CD4+ Treg cells. These results demonstrated that MK-6 is an efficient immunomodulator potentially used for improved immunotherapy with decreased adverse effects and attenuated Treg stimulation.


Assuntos
Linfócitos T CD4-Positivos/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Fatores Imunológicos/farmacologia , Linfócitos do Interstício Tumoral/efeitos dos fármacos , Linfócitos T Reguladores/efeitos dos fármacos , Animais , Linfócitos T CD4-Positivos/citologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Meia-Vida , Imunidade Celular , Subunidade gama Comum de Receptores de Interleucina/metabolismo , Interleucina-2/efeitos adversos , Interleucina-2/metabolismo , Interleucina-2/uso terapêutico , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Subunidade beta de Receptor de Interleucina-2/metabolismo , Linfócitos do Interstício Tumoral/citologia , Linfócitos do Interstício Tumoral/fisiologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Fosforilação , Fator de Transcrição STAT5/metabolismo , Albumina Sérica/metabolismo , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/fisiologia , Proteínas Supressoras de Tumor/metabolismo
12.
Cell Mol Life Sci ; 77(22): 4523-4551, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32448994

RESUMO

Organisms adapt to changing environments by adjusting their development, metabolism, and behavior to improve their chances of survival and reproduction. To achieve such flexibility, organisms must be able to sense and respond to changes in external environmental conditions and their internal state. Metabolic adaptation in response to altered nutrient availability is key to maintaining energy homeostasis and sustaining developmental growth. Furthermore, environmental variables exert major influences on growth and final adult body size in animals. This developmental plasticity depends on adaptive responses to internal state and external cues that are essential for developmental processes. Genetic studies have shown that the fruit fly Drosophila, similarly to mammals, regulates its metabolism, growth, and behavior in response to the environment through several key hormones including insulin, peptides with glucagon-like function, and steroid hormones. Here we review emerging evidence showing that various environmental cues and internal conditions are sensed in different organs that, via inter-organ communication, relay information to neuroendocrine centers that control insulin and steroid signaling. This review focuses on endocrine regulation of development, metabolism, and behavior in Drosophila, highlighting recent advances in the role of the neuroendocrine system as a signaling hub that integrates environmental inputs and drives adaptive responses.


Assuntos
Adaptação Fisiológica/fisiologia , Drosophila/metabolismo , Drosophila/fisiologia , Animais , Proteínas de Drosophila/metabolismo , Homeostase/fisiologia , Humanos , Hormônios de Inseto/metabolismo , Transdução de Sinais/fisiologia
13.
Heart Vessels ; 36(8): 1166-1174, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33725163

RESUMO

Cardiac implantable electronic devices (CIEDs) offer heart failure (HF) diagnostic information, including intrathoracic impedance (ITI) or physical activity (PA). However, few studies have evaluated the utility of these parameters measured by CIEDs with CorVue algorithm. The purpose of this study was to investigate the relationship between ITI alerts triggered by the CorVue algorithm and HF development. We also examined the association between device-measured PA and ITI alerts associated with HF development. We retrospectively studied consecutive patients with CIEDs equipped with CorVue algorithm, which were implanted between June 1, 2011 and August 31, 2019. These patients were divided into two groups: patients with decreased ITI followed by the ITI alerts (ITI alert group) and those without the alerts (non-ITI alert group). There were 35 and 14 patients in the ITI and non-ITI alert groups, respectively. A total of 96 ITI alerts were observed. ITI alerts associated with HF development were observed in 21% (20/96); whereas, ITI alerts not associated with HF development were observed in 79% (76/96). Accurate device-measured PA was confirmed in 76 ITI alerts, which consisted of 30 alerts with lower PA and 46 alerts without lower PA. ITI alerts associated with HF development were observed in 30% (9/30) of the alerts with lower PA, whereas observed only in 6.5% (3/46) of the alerts without lower PA. In conclusion, the CorVue ITI alerts indicated a high false-positive rate. However, device-measured PA may be useful to determine whether ITI alerts are associated with HF development or not, which was attributed to the high negative predictive value.


Assuntos
Desfibriladores Implantáveis , Insuficiência Cardíaca , Cardiografia de Impedância , Impedância Elétrica , Exercício Físico , Insuficiência Cardíaca/diagnóstico , Humanos , Estudos Prospectivos , Estudos Retrospectivos
14.
Gan To Kagaku Ryoho ; 48(13): 1573-1575, 2021 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-35046260

RESUMO

A sixty-something man presented with lower abdominal pain in early Y month 20XX, and was examined at the hospital's internal medicine outpatient clinic. An abdominal CT showed a soft tissue mass around the left hip joint, and multiple enlarged lymph nodes from inside the pelvis to the mesentery of the abdomen. We noted a small-intestinal intussusception in the lower right abdomen, and suspected malignant lymphoma. We did a CT-guided biopsy on the left hip joint soft tissue mass, and performed surgery on the small-intestinal intussusception. During surgery, we noted an approximately 30 cm ileal intussusception located about 60 cm from the terminal ileum, and enlarged lymph nodes in the nearby mesentery. We removed the ileal intussusception. The pathological diagnosis was myeloid sarcoma, and the soft tissue mass in the left hip joint was also diagnosed as myeloid sarcoma. We performed a bone-marrow biopsy at the hematology department, and diagnosed acute myeloid leukemia M2. We then started remission-induction therapy and consolidation therapy, and the patient was diagnosed as in remission in Y+5 month 20XX. We also need to keep in mind myeloid sarcoma in the intestine as a subtype of acute myeloid leukemia, as malignant tumor in the small intestine presenting with intussusception.


Assuntos
Intussuscepção , Sarcoma Mieloide , Dor Abdominal , Humanos , Intestino Delgado , Intussuscepção/etiologia , Intussuscepção/cirurgia , Masculino , Mesentério , Sarcoma Mieloide/complicações , Sarcoma Mieloide/cirurgia
15.
Cardiology ; 145(4): 199-202, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32018268

RESUMO

BACKGROUND: We recently reported a new approach, namely postconditioning with lactate-enriched blood (PCLeB), for cardioprotection in patients with ST-segment elevation myocardial infarction (STEMI). OBJECTIVES: We examined the effects of PCLeB on plasma NT-proBNP levels months after myocardial infarction (MI). METHODS: The study included consecutive patients (n = 31) undergoing percutaneous coronary intervention (PCI) for anterior STEMI within 12 h of symptom onset in our hospital between March 2014 and August 2018. We retrospectively compared plasma NT-proBNP levels several months after MI in these patients with those in historical control patients (n = 32). The control patients included consecutive patients who underwent successful PCI without PCLeB for anterior STEMI within 12 h of symptom onset in our hospital between March 2009 and February 2014. We compared the highest plasma NT-proBNP values 6-10 months after MI in the postconditioned patients with the lowest plasma NT-proBNP values 6-10 months after MI in the control patients. In the PCLeB protocol, the duration of each brief reperfusion was increased stepwise from 10 to 60 s. Lactated Ringer's solution (30 mL) was injected directly in the culprit coronary artery at the end of each brief reperfusion. Each ischemic episode lasted 60 s. RESULTS: Plasma NT-proBNP levels in the postconditioned patients months after MI (211 ± 207 pg/mL) were significantly lower than those in the control patients (516 ± 598 pg/mL; p < 0.0001). CONCLUSION: PCLeB was associated with reduced plasma NT-proBNP levels months after MI.


Assuntos
Infarto do Miocárdio , Intervenção Coronária Percutânea , Biomarcadores , Humanos , Ácido Láctico , Infarto do Miocárdio/terapia , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Estudos Retrospectivos
16.
Heart Vessels ; 35(6): 817-824, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31897640

RESUMO

Previous studies suggested that sleep-disordered breathing was associated with cardiovascular diseases such as heart failure (HF). Recently, algorithms of cardiac implantable electronic devices (CIEDs) have been developed to detect advanced sleep apnea (SA); the Apnea Scan (AP Scan) being an example. The purpose of this study was to investigate the association between respiratory disturbance index (RDI) measured using the AP Scan algorithm and HF development. We retrospectively studied consecutive patients with CIEDs equipped with the AP Scan algorithm which were implanted between December 1, 2011 and March 31, 2019. These patients were divided into 2 groups according to the trends of RDI: patients with a continually high RDI > 30 (severe SA group) and those without a continually high RDI (non-severe SA group). There were 16 and 46 patients in the severe and non-severe SA groups, respectively. Increased left ventricular end-diastolic and end-systolic dimensions were observed in the severe SA group. Regarding cardiovascular events, HF was observed in 8 patients (50.0%) in the severe SA group and 1 patient (2.2%) in the non-severe SA group; thus, there was a significantly higher proportion of patients with HF in the severe SA group. In conclusion, continually high RDI was associated with HF development in patients with CIEDs equipped with the AP Scan algorithm. Therefore, an elevated RDI may be a risk factor for the development of HF in patients with CIEDs.


Assuntos
Algoritmos , Cardiografia de Impedância/instrumentação , Desfibriladores Implantáveis , Insuficiência Cardíaca/etiologia , Pulmão/fisiopatologia , Marca-Passo Artificial , Respiração , Processamento de Sinais Assistido por Computador , Síndromes da Apneia do Sono/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Fatores de Risco de Doenças Cardíacas , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/fisiopatologia
17.
BMC Anesthesiol ; 20(1): 9, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910797

RESUMO

BACKGROUND: The purpose of this study is to investigate if a laryngeal mask could improve respiratory condition during radiofrequency catheter ablation (RFCA). METHODS: Twenty-four consecutive patients who underwent RFCA for atrial fibrillation were divided into two groups (Facemask group; n = 10, Laryngeal mask group; n = 14). All patients were completely sedated under intravenous anesthesia and fitted with artificial respirators during the RFCA. The capnography waveforms and their differential coefficients were analyzed to evaluate the changes of end-tidal CO2 (ETCO2) values, respiratory intervals, expiratory durations, and inspiratory durations. RESULTS: During the RFCA, ETCO2 values of the laryngeal mask group were higher than those of the facemask group (36.0 vs. 29.2 mmHg, p = 0.005). The respiratory interval was significantly longer in the laryngeal mask group than those in the facemask group (4.28 s vs.5.25 s, p < 0.001). In both expiratory and inspiratory phases, the mean of the maximum and minimum values of CO2 was significantly higher when using a laryngeal mask than when using a facemask. The inspiratory-expiratory ratio of the laryngeal mask group was significantly larger than that of the facemask group (1.59 vs. 1.27, p < 0.001). The total procedure duration, fluoroscopic duration and the ablation energy were significantly lower in the laryngeal mask group than in the facemask group. The ETCO2 value is the most influential parameter on the fluoroscopic duration during the RFCA procedure (ß = - 0.477, p = 0.029). CONCLUSIONS: The use of a laryngeal mask could stabilize respiration during intravenous anesthesia, which could improve the efficiency of RFCA.


Assuntos
Fibrilação Atrial/terapia , Ablação por Cateter/métodos , Máscaras Laríngeas , Máscaras , Respiração Artificial/métodos , Idoso , Fibrilação Atrial/diagnóstico por imagem , Dióxido de Carbono/sangue , Sedação Consciente , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Hinyokika Kiyo ; 66(4): 127-130, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32483947

RESUMO

A 71-year-old man with gross hematuria and urinary retention showed a 7×8 cm polycystic mass compressing the prostate on the right ventral side on pelvic magnetic resonance imaging (MRI). The prostate specific antigen (PSA) level was 6.47 ng/ml. Prostate biopsy histopathology was consistent with prostate ductal carcinoma. Considering the difficulty of surgical therapy, endocrine therapy was undertaken prior to surgery for seven months. Almost all of the cyst disappeared ; robot-assisted laparoscopic radical prostatectomy was then successfully performed. Prostate ductal carcinoma is a relatively rare pathology for which radical prostatectomy plays an important role if the disease is localized. However, when ductal carcinoma involves large cysts, surgical treatment may be difficult. This report discusses the usefulness of neoadjuvant endocrine therapy to reduce the size of the cystic lesions.


Assuntos
Carcinoma Ductal , Cistos , Laparoscopia , Neoplasias da Próstata/cirurgia , Robótica , Idoso , Humanos , Masculino , Terapia Neoadjuvante , Antígeno Prostático Específico , Prostatectomia
19.
PLoS Biol ; 14(2): e1002392, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26928023

RESUMO

In Drosophila, the fat body, functionally equivalent to the mammalian liver and adipocytes, plays a central role in regulating systemic growth in response to nutrition. The fat body senses intracellular amino acids through Target of Rapamycin (TOR) signaling, and produces an unidentified humoral factor(s) to regulate insulin-like peptide (ILP) synthesis and/or secretion in the insulin-producing cells. Here, we find that two peptides, Growth-Blocking Peptide (GBP1) and CG11395 (GBP2), are produced in the fat body in response to amino acids and TOR signaling. Reducing the expression of GBP1 and GBP2 (GBPs) specifically in the fat body results in smaller body size due to reduced growth rate. In addition, we found that GBPs stimulate ILP secretion from the insulin-producing cells, either directly or indirectly, thereby increasing insulin and insulin-like growth factor signaling activity throughout the body. Our findings fill an important gap in our understanding of how the fat body transmits nutritional information to the insulin producing cells to control body size.


Assuntos
Citocinas/metabolismo , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/fisiologia , Corpo Adiposo/metabolismo , Insulina/metabolismo , Somatomedinas/metabolismo , Animais , Animais Geneticamente Modificados , Tamanho Corporal , Encéfalo/metabolismo , Técnicas de Cultura , Feminino , Secreção de Insulina , Masculino , Serina-Treonina Quinases TOR/metabolismo
20.
PLoS Biol ; 14(8): e1002551, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27574994

RESUMO

[This corrects the article DOI: 10.1371/journal.pbio.1002392.].

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